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CYP2C19 Drug Metabolism Gene Test

South Dakota rates for HCPCS 81225

A blood or cheek-swab test that examines common variations in the CYP2C19 gene, which controls one of the liver enzymes that break medicines down. The result predicts whether a person clears certain drugs quickly, normally, or slowly, so a prescriber can pick a suitable medicine or adjust the dose. Clopidogrel, several antidepressants, and some acid-reducing medicines depend on this enzyme.

Rates data updated July 2026.

How much does CYP2C19 Drug Metabolism Gene Test cost?

$309

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $309 for this service. The price depends on where it is billed: about $437 from a physician practice, and about $282 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$437$229 to $676
FacilityA hospital or hospital-owned outpatient department$282$245 to $562

How much rates vary

Facilitymedian $282 · 10th to 90th $245 to $562Professionalmedian $437 · 10th to 90th $195 to $759
$200.0$500.0$1.0Kfacility $282professional $437

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$245.47
Median
$245.47
Typical High
$288.40
Aetna
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$229.09
Typical High
$275.42
Avera
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$309.03
Typical High
$309.03
Cigna
Setting
Facility
Modifier
Global
Typical Low
$562.34
Median
$562.34
Typical High
$562.34
Cigna
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$562.34
Typical High
$691.83
Medica
Setting
Facility
Modifier
Global
Typical Low
$275.42
Median
$331.13
Typical High
$812.83
Medica
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$1,445.44
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$416.87
Median
$676.08
Typical High
$794.33
United
Setting
Professional
Modifier
Global
Typical Low
$123.03
Median
$173.78
Typical High
$389.05
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$288.40
Median
$288.40
Typical High
$288.40

Where South Dakota sits

The same service costs 3.8 times more in Alaska than in Vermont. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

South Dakota $309 · 12th of 51
AK $661VT $174

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.